Randomized two of phosphodiesterase inhibitors versus catecholamines in patients with acutely decompensated heart failure

Increased neurohormone and cytokine concentrations are associated with adve rse outcome in patients with congestive heart failure, so minimizing these increases may improve outcome, even in the acute phase of decompensated hea rt failure, The present study was designed to test the hypothesis that phos phodiesterase inhibitors, but not catecholamines, could favorably affect ne urohormone and cytokine profiles in patients with acutely decompensated hea rt failure. Twenty-nine patients underwent monitoring using a Swan-Ganz cat heter and were randomly allocated to receive phosphodiesterase inhibitors ( PDEI group, n=19) or catecholamines (CA group, n=10). Pulmonary capillary w edge pressure decreased significantly in both groups and cardiac output sho wed a slight, but not statistically significant increase, in both groups. T here was a significant decrease in plasma brain natriuretic peptide concent ration in the PDEI group, but not in the CA group, whereas plasma interleuk in-6 concentration increased in the CA group, but not in the PDEI group. Ph osphodiesterase inhibitors favorably affect neurohormone and cytokine conce ntrations in patients with acutely decompensated heart failure.